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Supporting commissioners to put patients and the public at the heart of healthcare decisions – Olivia Butterworth

Three years on from the creation of Clinical Commissioning Groups and NHS England, the Head of Public Participation at NHS England asks how can we ensure that patients and the public are involved in their own care and decisions about how health services are provided?

In 2013 NHS England launched Transforming Participation in Health and Care, setting out statutory guidance on how to involve the public in the commissioning of services, and people in their own care.

This was an opportunity to support the system to put patients at the heart of the NHS.

Since ‘Transforming Participation’ was published, we’ve moved on; the guidance has become outdated and there’s now a wealth of new resources, tools and good practice available. Many of these resources are now on the NHS England website, on our Involvement hub.

In light of this, we think that now is the time to refresh the guidance and make sure it meets the needs of CCGs now and for the years to come, as we work to transform the NHS.

We know that many CCGs across England already do excellent work to involve the public and to enable patients to play a central part in their own care. But we also know we can do more to support them.

We’ve taken time to reflect on existing insight and have done some initial scoping to look at the objectives of the refreshed guidance.

We are planning to produce two sets of guidance to outline CCGs’ legal duties – the duty to make arrangements for public involvement in commissioning and the duty to promote the involvement of each patient in their own care. The guidance will show how CCGs can best meet their legal duties in practice and also highlight the importance of patients and the public in transforming services – how we can work together to reduce health inequalities, improve quality and outcomes, and make services more sustainable.

We also want to share learning, experience, good practice and signpost people to new resources and the best examples of what good involvement looks like and the impact it can have in improving health and care services.

In the spirit of the guidance, we want to work with others to do this – it’s important that what we develop meets the needs of CCGs, patients and the public and the organisations that represent them.

We want your input to the development process and want to hear your feedback on how we can support the system with this refreshed guidance. We are already working with a number of stakeholders to develop material and we are approaching a range of partners in the coming weeks.

So, whether you are a working in a CCG or are a healthcare provider, a patient, carer, volunteer or part of a community or voluntary sector group we would really welcome your thoughts. It would be helpful if you could focus your feedback on:

  • The features of the existing statutory guidance (Transforming Participation in Health and Care) that you would keep and include in the refreshed guidance.
  • What you would like to see in the refreshed guidance to meet current system needs.
  • Details of any good practice (public participation or patient involvement in care) that you want to share with others.

If you would like to have your say on the refreshed guidance or you want updates on its development, please email us england.nhs.participation@nhs.net by Friday 13 January 2017 and tell us your name, organisation and contact details.


Image of Olivia ButterworthOlivia Butterworth is the Head of Public Voice for NHS England where she works to ensure citizens and communities have a voice that influences the development, design and delivery of our health and care services.

Her key responsibility is the development of the Citizens’ Assembly for NHS England which will see a revolution in public participation and transparency.

Olivia was previously the strategic lead within the Department of Health on partnerships with the voluntary and community sector and more widely the ‘Big Society’ vision. She led the 2007 strategic review of DH voluntary sector funding and investment which resulted in the creation of the Voluntary Sector Strategic Partner Programme, the Innovation, Excellence and Strategic Development (IESD) Fund and the Health and Social Care Volunteering Fund.

Olivia has a background in Community Development and education with a passion for empowering people to be their own change. She has worked with a wide and diverse range of voluntary sector organisations, both in paid and voluntary roles, providing support with organisational development, developing services, engagement, involvement and fundraising.

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16 comments

  1. millieanne says:

    I agree fully with Kassander. Whatever happened to NHS Citizen? Now I know, assassinated.
    Are you also aware that CCGs, commissioners and CSUs ignore “guidance” on involvement? They make all the decisions and if we are really lucky, we are asked for comment. That’s NOT what the Acts say. They talk about planning, development etc but it just doesn’t happen. Commissioners are not taught to engage. They are taught to commission first and when patients and service users don’t agree, they might listen but do nothing else. It’s not working. Public and patients are, as you say, a massive resource but largely unused.

  2. Kassander says:

    Any chance of any NEWS, please?
    Has nothing happened on your patch in the last couple of months?
    Have you got nothing to tell us about what is to come in the forthcoming weeks?
    It’s almost 12 months since Ms A Singh (Dir PPPI) assassinated NHSE Citizen-Gather, and knocking on for 18 weeks since NHSE Board approved the NEW version.
    That magic time = 18 weeks!!

  3. Kassander says:

    ” … and tell us your name, organisation and contact details.”
    ——
    Oh! One has tgo be part of an organisation to be taken notice of.
    This is clearly against the letter, and the spirit, of the 2012 Act – S13Q.
    It is suspected that NHSE is crowding out P&P in favour of your chums in VCS, and now thew latest additions:
    Self-appointed and Self-designated Patient Leaders
    and, stop press:
    Social Enterprises.
    Who next?
    Big Pharma?
    Med. Insc. Coys?
    (Sir?) Phil Green?

  4. stephenie robinson says:

    My main focus is the Transgender community and what can be expected from the NHS since many GP’s refuse such patients hormone therapy driving them to seek black market supply, costing the NHS more in revisionn treatments. I would like to see Facial Feminisation surgery offered to male to Female Transgender patients that need it to help them fit their new role based upon their clinical need

  5. Nora Everitt says:

    Thank you for your reply, but many queries remain unanswered.
    Involvement or Consultation?
    Asking for emails giving our views is effectively a consultation but does not follow consultation guidance, or the co-production ethos you promote.
    Involving the public?
    You describe working with stakeholders. BUT your legal duty to involve the public requires you to “secure that individuals to whom the services are being or may be provided are involved”. This is not happening. The law allows involving individuals by “being consulted or provided with information or in other ways”. You have neither consulted, nor provided information about the changes to NHS Citizen. You refer to a 2015 Board and not the 2016 Board decision to change NHS Citizen – which will effectively exclude individual members of the public from being involved – and your ability to meet your legal duty.
    Patient Representatives?
    YOU select these, but they have no reporting mechanisms provided to communicate with individuals and pass on their views as the law requires. They can only represent their own personal experience, knowledge and contacts.
    Please be honest with us.
    Please review, WITH us, your involvement plans and practice – so you involve the English people inclusively in decisions about how you plan to involve them in NHS England’s decisions about services.

  6. NHS England says:

    Thank you for the comments on my blog about the refresh of Transforming Participation. In response to the questions raised I wanted to clarify the work we are undertaking on the refresh of the guidance and why.

    One of the questions you raise is about why the guidance is outdated. The refresh of the guidance is being carried out to reflect where we are now, and the changes that have happened since the original guidance was published, and NHS England and Clinical Commissioning Groups (CCGs) were new organisations.

    Since 2013, new guidance has been introduced and this needs to be reflected in the statutory guidance to give an accurate picture of patient and public participation, both for those working in the NHS and those who use its services. For example NHS England’s Patient and Public Participation Policy and guidance for CCGs on the annual reporting of patient and public involvement in commissioning have been introduced and supersede some of the advice set out in Transforming Participation.

    There is also new good practice and a range of new resources that can support commissioners to involve patients and the public. We would like to share these across the system. However, we recognise that many of the principles of Transforming Participation are still the same and we do not want to lose the content and principles that people find useful. This is why we are asking for feedback, especially on content that should be retained and new content that’s needed.

    The refresh of Transforming Participation was approved by the NHS England Board. It was included in a paper put to the Board in November 2015 on the subject of ‘strengthening patient and public participation in the work of NHS England’.

    In terms of involvement, we are working with a number of stakeholders, including patient representatives, patient groups, and users of the guidance to establish what the refreshed version should look like. We also welcome comments direct from patients, carers, volunteers and anyone else with an interest in the guidance. Feedback can be sent to us at england.nhs.participation@nhs.net

    NHS England does continue to involve the public in a number of ways, for example through groups and networks such as the learning disability advisory group and the NHS Youth Forum, and also through formal patient representative roles. We promote these opportunities through our Involvement hub and in our newsletter for patients and the public, In Touch.

    Kind regards,

    Oliver Butterworth

  7. Nora Everitt says:

    Some very relevant points made below. Ms Butterworth, can I ask if your invitation is meant as ‘involvement’ or as a ‘consultation’? The feedback deadline is very short for either PPI/E tool, given Xmas & NY.
    Can I also ask what particular parts of the ‘Transforming Participation’ guidance is ‘outdated’?
    It is a long document and includes much detail and sound advice, based on best practice in PPI/E.
    Please can you explain which particular parts of this PPI/E best practice has changed?
    I know NHS England no longer involves the public directly, and their PPI/E process is now controlled, no longer open and transparent. But this new direction is NOT about best practice in involvement/engagement – it is an NHS England’s management choice.

  8. Kassander says:

    Ms Butterworth you state:
    “In 2013 NHS England launched Transforming Participation in Health and Care, setting out statutory guidance on how to involve the public in the commissioning of services, and people in their own care.

    This was an opportunity to support the system to put patients at the heart of the NHS.”

    Noted that the sub-heading was ‘The NHS belongs to us all’

    Where might one obtain a copy of the Official Report on this project, please?

    After all, you do write

    “Since ‘Transforming Participation’ was published, we’ve moved on; the guidance has become outdated … ”

    So presumably, that was one of the conclusions reached in the Report which strangely you don’t refer to.
    It would be rather good if a reply was posted by you, not by an anonymous machine which churns out standard responses directing one to NHSE’s version of Bleak House.
    ———-
    https://nhspublicvoice.wordpress.com/

    • KASSANDER says:

      The SECOND time of asking:
      ———-
      “Where might one obtain a copy of the Official Report on this project, please?

      After all, you do write

      “Since ‘Transforming Participation’ was published, we’ve moved on; the guidance has become outdated … ”

      So presumably, that was one of the conclusions reached in the Report which strangely you don’t refer to.
      It would be rather good if a reply was posted by you, not by an anonymous machine which churns out standard responses directing one to NHSE’s version of Bleak House.
      ———-
      https://nhspublicvoice.wordpress.com/

  9. Kassander says:

    At the NHSE Board meeting on 29 Sept 2016 the NEW Citizen-Gather, to replace the one assassinated by Ms Anu Singh (Dir. PPPI) last Spring, was promised by Ms Cummings (Chief Nurse, and an Exec Dir. NHSE) for the 1st weeks in October (2016).
    Has this one met a summary termination without trial too?

    • Kassander says:

      Why are you hiding, Ms Butterworth?
      What are you hiding, Ms Butterworth?

      You’ve had approaching a month to find the answer to my simple query. But you haven’t.

      Ms Butterworth, you claim to be “Head of Public Voice for NHS England”.
      You’re not Voice-ing for or to this member of the Public.
      Nor listening TO my Voice.

      What ARE you doing to justify your title, please?

      https://nhspublicvoice.wordpress.com/

  10. KASSANDER says:

    Welcome back – hope you had a good rest in your garden.
    “Olivia was previously the strategic lead within the Department of Health on partnerships with the voluntary and community sector and more widely the ‘Big Society’ vision.”
    Errr. What ever happened to:
    # The Big Society
    # We’re all in this together
    # Nothing about me without me
    # NHS Citizen-Gather which was assasinated overnight by Ms Anu Singh – Dir PPPI
    # The New Citizen which is a carve-up sprung on NHSE Board without any input from the P&P who attended the so-called Consultative Conference on 12/09/16 – where we were promised that there were No done deals – and then there were.
    # Where’s the implementation of the hi-jacked New Citizen-Gather which was promised at the Board in 2 weeks, and is now still in limbo?
    # What investigation has/will be, carried out into your stewardship of the FOUR outsourced providers who ‘ran’ the now failed & ‘terminated with extreme prejudice’, NHSE Citizen-Gather £3m + project?

    • NHS England says:

      Dear Kassander,
      Thank you for your comment on this blog. If you would like to make a complaint about our work you can contact the NHS England Customer Contact Centre, the email address is england.contactus@nhs.net
      Kind regards,
      NHS England

      • Kassander says:

        I am Kassander, not Brave Ulysses / Odysseus, and so have no intention of entering into discussions with NHSE’s Charybdis.
        And as for you 1st responder, when will the author of the article reply? After all, their job is about two-way communication with the owners of Our=NHS.
        In case you’ve forgotten, that’s US, the P&P.
        You are the executive branch, anonymous one.

        • KASSANDER says:

          Wot?
          No reply, Anonymous 1st Responder?
          Poor show!
          ——-=–
          It’s Our=NHS
          Where’s Our=Voice?
          # NOT the one NHSE chooses for us.
          # NOT Self-appointed, self-designated, Patient Leaders
          # NOT Government sponsored, un-critical friend from VCS
          # YES, to Our=Representatives
          —–
          https://nhspublicvoice.wordpress.com/